Management of carcinoma breast in 2nd trimester are all except

If the diagnosis of breast cancer is made in the first or early second trimester of pregnancy, lumpectomy and axillary dissection can be followed by chemotherapy after the first trimester and radiation after delivery. Chemotherapy is indicated for node-positive cancers or node-negative tumors greater than 1 cm. Current chemotherapeutic regimens are relatively safe after the first trimester, when the teratogenic risk is greatest. Generally, treatment regimens are the same as for non- pregnant patients with dose alterations because the increased plasma volume, the hypoalbuminemia, and the fact that almost all chemotherapeutic agents cross the placenta change the pharmacokinetics of the drugs. Ref: Sabiston 20th edition Pgno: 2060